tbuckley/cabot-search huggingface dataset:
Assessment of Artificial Intelligence Chatbot Responses to Top Searched Queries About Cancer
Authors: Alexander Pan, David Musheyev, Daniel Bockelman, Stacy Loeb, Abdo E. Kabarriti
Journal: JAMA Oncology (2023)

Importance Consumers are increasingly using artificial intelligence (AI) chatbots as a source of information. However, the quality of the cancer information generated by these chatbots has not yet been evaluated using validated instruments. Objective To characterize the quality of information and presence of misinformation about skin, lung, breast, colorectal, and prostate cancers generated by 4 AI chatbots. Design, Setting, and Participants This cross-sectional study assessed AI chatbots’ text responses to the 5 most commonly searched queries related to the 5 most common cancers using validated instruments. Search data were extracted from the publicly available Google Trends platform and identical prompts were used to generate responses from 4 AI chatbots: ChatGPT version 3.5 (OpenAI), Perplexity (Perplexity.AI), Chatsonic (Writesonic), and Bing AI (Microsoft). Exposures Google Trends’ top 5 search queries related to skin, lung, breast, colorectal, and prostate cancer from January 1, 2021, to January 1, 2023, were input into 4 AI chatbots. Main Outcomes and Measures The primary outcomes were the quality of consumer health information based on the validated DISCERN instrument (scores from 1 [low] to 5 [high] for quality of information) and the understandability and actionability of this information based on the understandability and actionability domains of the Patient Education Materials Assessment Tool (PEMAT) (scores of 0%-100%, with higher scores indicating a higher level of understandability and actionability). Secondary outcomes included misinformation scored using a 5-item Likert scale (scores from 1 [no misinformation] to 5 [high misinformation]) and readability assessed using the Flesch-Kincaid Grade Level readability score. Results The analysis included 100 responses from 4 chatbots about the 5 most common search queries for skin, lung, breast, colorectal, and prostate cancer. The quality of text responses generated by the 4 AI chatbots was good (median [range] DISCERN score, 5 [2-5]) and no misinformation was identified. Understandability was moderate (median [range] PEMAT Understandability score, 66.7% [33.3%-90.1%]), and actionability was poor (median [range] PEMAT Actionability score, 20.0% [0%-40.0%]). The responses were written at the college level based on the Flesch-Kincaid Grade Level score. Conclusions and Relevance Findings of this cross-sectional study suggest that AI chatbots generally produce accurate information for the top cancer-related search queries, but the responses are not readily actionable and are written at a college reading level. These limitations suggest that AI chatbots should be used supplementarily and not as a primary source for medical information.
Improving Dialysis Techniques for Patients?
Authors: Thomas A. Golper
Journal: New England Journal of Medicine (2023)

We do not know the full cascade of metabolic changes that occur in a person when kidneys fail. However, we observe multisystem progressive deterioration as kidney function declines. Once end-stage kidney disease has developed, transplantation offers the best outcome but at the expense of immunosuppression. Currently, the scarcity of replacement organs mandates that depuration occur by means of dialytic therapy, which typically involves extracorporeal cleansing with dialysate during hemodialysis. In this procedure, blood and dialysate are separated by a semipermeable porous membrane through which water and solutes pass, limited by the water-permeability characteristics and pore widths of the membrane. Molecules . . .
P30 Blisters in a newborn: all that glitters is not gold
Authors: Pablo Lopez Balboa, Anna Martinez, Gabriela Petrof
Journal: British Journal of Dermatology (2023)

Abstract Mastocytosis is a rare and clinically heterogeneous disease characterized by abnormal accumulation of mast cells in various tissues. There are three major types of cutaneous mastocytosis (CM): diffuse cutaneous mastocytosis (DCM), urticaria pigmentosa and solitary mastocytoma, which is the most common form before the age of 3 months: 90% of CM cases present before 2 years of age, and congenital mastocytosis has been described in 23% of those. Solitary mastocytoma has been associated with a mutation of the KIT gene. A male infant was born at 39 weeks, with a large, indurated, blistering, ulcerated plaque containing yellow serous fluid affecting half his right calf. His nails and oral mucosa were normal. Our centre was contacted on suspected diagnosis of inherited epidermolysis bullosa (EB). There was no family history of EB, and the parents were not related. Initial testing showed a PCR positive for HSV type 1 and treatment with aciclovir and cefotaxime was initiated. There was no improvement after 2 weeks of treatment. Viral and bacterial skin swab were negative. A skin biopsy and ultrasound were performed showing extensive superficial hypoechoic lesion and reactive popliteal lymph nodes and the biopsy confirmed the diagnosis of mastocytoma. Bloods including tryptase level and abdominal ultrasound were normal. The lesion healed within 4 weeks with dressings and topical steroids. This case of a single isolated congenital mastocytoma shows the broad differential diagnoses that must be considered in the evaluation of bullous lesions in a newborn. It is key to biopsy early and always exclude ­infection.
P06 Atopic dermatitis and psoriasis in children, and SARS-CoV-2 infection: different impact of the infection on these dermatoses, and of these dermatoses on the infection?
Authors: Emmanuel Mahé, Jinane Zitouni, Maud Amy de la Breteque
Journal: British Journal of Dermatology (2023)

Abstract The SARS-CoV-2 pandemic has raised many questions regarding chronic inflammatory dermatoses and their treatments. Atopic dermatitis (AD) and psoriasis are chronic inflammatory dermatoses with different immunological profiles. Their susceptibility to infections also differs. We were interested in the link between SARS-CoV-2 infection and these two dermatoses in children: different impact of the infection on AD and psoriasis (disease flare-ups), and of these two dermatoses on the severity of this infection (severity). This was a single-centre study of children with AD or psoriasis or those who developed these dermatoses within 1 month of infection, and who developed a SARS-CoV-2 infection. Thirty-two children with AD and 66 with psoriasis were included. Age, sex, frequency of overweight and frequency of systemic treatments (systemic or biotherapy) were not different in the two groups. The frequency of symptomatic forms and the duration of symptoms were not statistically different between the two groups. In 15.6% of AD and 12.7% of psoriasis (P = 0.69), a worsening of symptoms was noted in the month following the onset of the infection. De novo psoriasis was diagnosed in three cases, but no AD. There was no difference in the impact of SARS-CoV-2 infection on the evolution of these two dermatoses, with the possible exception of the appearance of post-infection psoriasis, which was not observed with AD. Similarly, these two diseases did not seem to have a different impact on the severity of SARS-CoV-2 infection. These results should be confirmed with larger cohorts such as Secure-AD and Chi-PsoCov.
P32 ‘Skin fade’ haircut: an independent risk factor for tinea capitis?
Authors: Lokapriya Ananthan, Iman Hamid, Richard Goodwin
Journal: British Journal of Dermatology (2023)

Abstract Tinea capitis is a highly contagious infection, with peak incidence at 3–9 years; transmission occurs between infected persons or via contaminated surfaces. We examine three different cases, all presented to our department this summer. Each gave a synchronous history of a friend or family member that contracted tinea capitis from the same ‘Turkish barbershop’ visit. We compare similar clinical features and timeframes. Two brothers aged 12 and 9 years, presented with multiple inflamed scaly plaques of alopecia on the occipital scalp. An 8-year-old boy presented with a 3-month history of tinea capitis infection affecting his occipital and temporal scalp. A 9-year-old boy presented with a 2-month history of inflammatory scaling scalp alopecia, spreading to involve his face and neck. All three groups attended different schools, different barbershops and had received a ‘skin fade’ haircut a few weeks prior to developing symptoms. Mycology confirmed Trichophyton tonsurans. ‘Skin fade’ is a type of haircut that has a graded hair length, starting at top of the head and gradually getting shorter towards the neckline. This is produced by using clippers and often cut-throat razors. The technique was introduced in 1930s. Its popularity has varied since and has enjoyed another resurgence recently in South Wales. T. tonsurans is well recognized as an important cause of inflammatory scarring alopecia in South Wales and barbers represent an important source of cross-contamination if hygiene measures are not followed carefully. These consecutive cases suggest that ‘skin fade’ haircuts represent a risk factor for the spread of tinea capitis.
P05 Biologics combined with conventional systemic agents for the treatment of children with severe psoriasis: real-life data from the BiPe cohorts
Authors: Emmanuel Mahé, Smaïl Hadj-Rabia, Juliette Mazereeuw-Hautier, Stéphanie Mallet, Alice Phan, Maëlle Severino-Freire, Franck Boralevi, Hélène Aubert, Hugue Barthelemy, Céline Girard, Ludovic Martin, Sébastien Barbarot, Vito Di Lernia
Journal: British Journal of Dermatology (2023)

Abstract Combined therapies, defined as treatment modalities involving combinations of two or more drugs, are used with three main aims: to increase the efficacy of each drug; to reduce the toxicity of each drug; and, in some cases, to reduce costs by reducing the required dosages of each treatment. We explored the use of combinations of conventional systemic therapies and biologics in children with psoriasis in daily practice from the 170 children in the Franco–Italian BiPe cohorts to evaluate the use, efficacy and safety of combined conventional systemic–biologic therapies. In total, 33 children (19.4%) from 13 dermatology centres received 48 combined conventional systemic–biologic therapies (cumulative duration 43.6 years), including three triple combination therapies (acitretin–methotrexate, with a TNF-α inhibitor). Fourteen different combinations were used, most frequently etanercept–acitretin (n = 10), adalimumab–acitretin (n = 7), adalimumab–methotrexate (n = 5) and ustekinumab–methotrexate (n = 5). The combined therapies were started at biologic initiation in 41 cases (85.4%), and after a period of biologic monotherapy in the remaining seven cases. Mean PGA and PASI scores decreased between baseline and M3 with all the combinations used. Four serious adverse events were reported, all with favourable outcomes. Combined therapies have been used frequently in the treatment of childhood psoriasis, in a range of clinical situations and in variable drug combinations, without significant toxicity. Although the use of these combined therapies needs to be clarified in future management guidelines, these combined therapies should be considered for the treatment of children with severe psoriasis, psoriatic arthritis and recalcitrant ­disease.
P09 A case series of anetodermic pilomatrixomas
Authors: Evangelia Vetsiou, Julia Gass, Sarah McDonald, Niki Stefanos, Ed Rytina, Nigel Burrows
Journal: British Journal of Dermatology (2023)

Abstract Pilomatrixoma is a benign tumour that arises from the base of the hair follicle matrix. Anetodermic changes overlying the tumour occur in only 2% of the cases. The aim of this study is to evaluate a case series of paediatric patients who presented with anetodermic pilomatrixoma to our Paediatric Dermatology department. A retrospective analysis of all our paediatric cases with a clinical diagnosis of anetodermic pilomatrixoma within the last 4 years was made. Data were collected according to age at time of presentation, suspected clinical diagnosis, histopathological features, treatment and postoperative outcomes. Five cases were identified. All were referred as a rapidly growing tumour. The median age of onset was 15 years. The male : female ratio was 3 : 2; one presented on the neck, two on the upper limbs and two on the back. Two out of three patients reported that the lesions were painful. Clinical suspicion of anetodermic pilomatrixoma (large, atrophic, wrinkled lesion overlying a firm subcutaneous mass) was made prior to surgical removal. Four were confirmed histopathologically. Simple excision was carried out without any postoperative complications. There have been no recurrences. Anetodermic pilomatrixoma, also referred to as pseudobullous pilomatrixoma, is a rare variant of pilomatrixomas, occurring more frequently in the upper body. It presents with identifiable features but should be differentiated from other skin tumours. Pain can be a symptom due to the size of the lesion. Surgical removal is the gold standard treatment with a low recurrence rate.
O06 Novel multispectral imaging vs. clinical assessment to assess disease activity in paediatric morphoea
Authors: Cathal O’Connor, Siobhan McCarthy, Michael McCauliffe, Mary Bennett
Journal: British Journal of Dermatology (2023)

Abstract The assessment of disease activity in paediatric morphoea is challenging. Clinical examination and the Localized Scleroderma Cutaneous Assessment Tool (LoSCAT) are subjective. Thermography is the monitoring tool of choice but has a high rate of false-positive results, with low specificity. Multispectral imaging (measuring depth, volume, haemoglobin and melanin) may provide a noninvasive objective assessment of disease activity. The aim of this study was to compare activity assessment with multispectral imaging vs. clinical assessment in children with morphoea. 3D images of site-matched affected and unaffected skin were obtained using a handheld portable Antera 3D camera (Miravex Ltd). Analysis of depth, volume, haemoglobin and melanin was performed using the Antera Clinical Studies software. Objective and subjective clinical assessment was performed using LoSCAT and Children's Dermatology Life Quality Index (CDLQI). To date, 17 children (age range 7–18 years) have been recruited. Two-thirds (65%) had linear morphoea and 58% were treated with systemic agents (pulsed methylprednisolone, methotrexate, mycophenolate mofetil, abatacept). Average LoSCAT scores were 20.6 (range 5–73), and average CDLQI scores were 3.7 (range 0–14). The average haemoglobin gradient between affected and unaffected skin was 0.3 in children with active disease and 0.08 in those who had persistent disease remission (P &amp;lt; 0.0001). The sensitivity of multispectral imaging in paediatric morphoea is 90% with specificity of 100%, giving a positive predictive value of 100%, and a negative predictive value of 95%. Multispectral imaging of affected skin may aid activity detection in paediatric morphoea and is particularly useful in darkly pigmented skin.
Cdc73 protects Notch-induced T-cell leukemia cells from DNA damage and mitochondrial stress
Authors: Ashley F. Melnick, Carea Mullin, Karena Lin, Anna C. McCarter, Shannon Liang, Yiran E. Liu, Qing Wang, Nicole A. Jerome, Elizabeth Choe, Nicholas Kunnath, Geethika Bodanapu, Fatema Akter, Brian Magnuson, Surinder Kumar, David B. Lombard, Andrew G. Muntean, Mats Ljungman, JoAnn Sekiguchi, Russell J. H. Ryan, Mark Y. Chiang
Journal: Blood (2023)
Exploiting the CD200-CD200R immune checkpoint axis in multiple myeloma to enhance CAR T-cell therapy
Authors: Yan Tang, Wei Liu, Siddhant Kadu, Omar Johnson, Zainul S. Hasanali, Andre Kelly, Alexander Shestov, Raymone Pajarillo, Eli Greenblatt, Matthew Holmes, Li-Ping Wang, Natalie Shih, Roddy S. O’Connor, Marco Ruella, Alfred L. Garfall, David Allman, Dan T. Vogl, Adam Cohen, Carl H. June, Neil C. Sheppard
Journal: Blood (2023)

Abstract Patients with multiple myeloma (MM) treated with B-cell maturation antigen (BCMA)-specific chimeric antigen receptor (CAR) T cells usually relapse with BCMA+ disease, indicative of CAR T-cell suppression. CD200 is an immune checkpoint that is overexpressed on aberrant plasma cells (aPCs) in MM and is an independent negative prognostic factor for survival. However, CD200 is not present on MM cell lines, a potential limitation of current preclinical models. We engineered MM cell lines to express CD200 at levels equivalent to those found on aPCs in MM and show that these are sufficient to suppress clinical-stage CAR T-cells targeting BCMA or the Tn glycoform of mucin 1 (TnMUC1), costimulated by 4-1BB and CD2, respectively. To prevent CD200-mediated suppression of CAR T cells, we compared CRISPR-Cas9–mediated knockout of the CD200 receptor (CD200RKO), to coexpression of versions of the CD200 receptor that were nonsignaling, that is, dominant negative (CD200RDN), or that leveraged the CD200 signal to provide CD28 costimulation (CD200R-CD28 switch). We found that the CD200R-CD28 switch potently enhanced the polyfunctionality of CAR T cells, and improved cytotoxicity, proliferative capacity, CAR T-cell metabolism, and performance in a chronic antigen exposure assay. CD200RDN provided modest benefits, but surprisingly, the CD200RKO was detrimental to CAR T-cell activity, adversely affecting CAR T-cell metabolism. These patterns held up in murine xenograft models of plasmacytoma, and disseminated bone marrow predominant disease. Our findings underscore the importance of CD200-mediated immune suppression in CAR T-cell therapy of MM, and highlight a promising approach to enhance such therapies by leveraging CD200 expression on aPCs to provide costimulation via a CD200R-CD28 switch.
Inhibition of NAD+-Dependent Metabolic Processes Induces Cellular Necrosis and Tumor Regression in Rhabdomyosarcoma Models
Authors: Grace B. McKay-Corkum, Victor J. Collins, Choh Yeung, Takeshi Ito, Sameer H. Issaq, David Holland, Ksenia Vulikh, Yiping Zhang, Unsun Lee, Haiyan Lei, Arnulfo Mendoza, Jack F. Shern, Marielle E. Yohe, Kazutoshi Yamamoto, Kelli Wilson, Jiuping Ji, Baktiar O. Karim, Craig J. Thomas, Murali C. Krishna, Leonard M. Neckers, Christine M. Heske
Journal: Clinical Cancer Research (2023)

Abstract Purpose: Deregulated metabolism in cancer cells represents a vulnerability that may be therapeutically exploited to benefit patients. One such target is nicotinamide phosphoribosyltransferase (NAMPT), the rate-limiting enzyme in the NAD+ salvage pathway. NAMPT is necessary for efficient NAD+ production and may be exploited in cells with increased metabolic demands. We have identified NAMPT as a dependency in rhabdomyosarcoma (RMS), a malignancy for which novel therapies are critically needed. Here we describe the effect of NAMPT inhibition on RMS proliferation and metabolism in vitro and in vivo. Experimental Design: Assays of proliferation and cell death were used to determine the effects of pharmacologic NAMPT inhibition in a panel of ten molecularly diverse RMS cell lines. Mechanism of the clinical NAMPTi OT-82 was determined using measures of NAD+ and downstream NAD+-dependent functions, including energy metabolism. We used orthotopic xenograft models to examine tolerability, efficacy, and drug mechanism in vivo. Results: Across all ten RMS cell lines, OT-82 depleted NAD+ and inhibited cell growth at concentrations ≤1 nmol/L. Significant impairment of glycolysis was a universal finding, with some cell lines also exhibiting diminished oxidative phosphorylation. Most cell lines experienced profound depletion of ATP with subsequent irreversible necrotic cell death. Importantly, loss of NAD and glycolytic activity were confirmed in orthotopic in vivo models, which exhibited complete tumor regressions with OT-82 treatment delivered on the clinical schedule. Conclusions: RMS is highly vulnerable to NAMPT inhibition. These findings underscore the need for further clinical study of this class of agents for this malignancy.
Covid-19: Scientists sound alarm over new BA.2.86 “Pirola” variant
Authors: Mun-Keat Looi
Journal: BMJ (2023)

A new SARS-CoV-2 subvariant with a high number of mutations that could help it neutralise the immune system has emerged in four countries, raising alarm among scientists."BA.2.86 is the most striking SARS-CoV-2 strain the world has witnessed since the emergence of omicron," said Francois Balloux, professor of computational systems biology and director of University College London's Genetics Institute.Genetic sequencing has found BA.2.86 in six covid cases so far, the earliest being in Denmark on 24 July.The other cases were from Israel, the UK, and the US.None of the cases seem linked.The UK Health Security Agency said that the UK case was in a person with no recent travel history, suggesting a degree of community transmission within the UK.
Covid-19: Lockdowns and masks helped reduce transmission, expert group finds
Authors: Elisabeth Mahase
Journal: BMJ (2023)

Covid-19: Lockdowns and masks helped reduce transmission, expert group finds Elisabeth MahaseNon-pharmaceutical interventions (NPIs) were "unequivocally" effective when rolled out in tandem during the covid pandemic and led to "powerful, effective and prolonged reductions in viral transmission," says a report by a team of experts brought together by the Royal Society.
Fragmentation of care between intensive and primary care settings and opportunities for improvement
Authors: Nina Leggett, Kate Emery, Thomas C Rollinson, Adam Deane, Craig French, Jo-Anne Manski Nankervis, Glenn Eastwood, Briannah Miles, Mark Merolli, Yasmine Ali Abdelhamid, Kimberley Joy Haines
Journal: Thorax (2023)

Purpose To explore the gaps in care provided across the transitions from the intensive care unit (ICU) to primary care, in order to improve post-ICU care. Methods Semistructured interviews with three participant groups: intensivists, general practitioners (GPs) and patients and carers with framework analysis of textual data were used to investigate experiences of transitions of care post-ICU. Participants were purposively sampled for diversity. Eligible patients were adults, mechanically ventilated for &gt;24 hours, with access to a video-enabled device. Exclusion criteria were non-English speaking and any cognitive/neurological limitation precluding interview participation. Results A total of 46 interviews (15 patients, 8 caregivers, 15 intensivists and 8 GPs) were completed. Eight themes were identified, and categorised into three healthcare tiers. Tier 1, health system factors : (1) fragmentation of care; (2) communication gaps; (3) limited awareness and recognition of issues beyond the ICU; (4) lack of a specialised ICU follow-up pathway; Tier 2, clinician factors : (5) relationships among ICU, hospitals, GPs and patients and carers; (6) need for clinician role definition and clarity in ICU follow-up; Tier 3, patient and carer factors : (7) patient autonomy and self-actualisation and (8) the evolving caregiver role. A conceptual model was developed, highlighting bidirectional feedback loops between hospital and primary care. Conclusion This study identified gaps in care between ICU discharge and reintegration with primary care from the lived experience of patients, caregivers, intensivists and GPs. These data provide foci for future interventional research to improve the integration of care for this vulnerable and underserved cohort.